Carrie Milligan graduated from the University of Stirling in November 2016 with a Masters in Advanced Practice. Her dissertation was a Quality Improvement Project and focused within her work place.
She was awarded a Research-Based Learning Prize for her dissertation titled: Maintaining the functional ability and quality of life of patients leaving hospital: improving information sharing with care home staff on discharge from an organic assessment ward.
We found out about Carrie and her work:
Tell us about your project:
I am a Specialist Occupational Therapist working in older peoples’ mental health. The project was focused in the organic assessment ward that I work within. It looked at the communication process from the inpatient setting to the care home. Our patient group is complex, and admission lengths at the commencement of the project were, on average, 98 days. There is some evidence that patients’ quality of life and functional ability decreases on discharge from hospital. I wondered if improved information sharing could also lead to improved outcomes for patients.
The discharge communication process is reliant on one nurse disseminating the assessments, interventions and treatments of the multi-disciplinary team on discharge. This means that important information from other clinical disciplines, such as occupational therapy, were not being shared with care homes when patients were discharged from hospital. Consistent and timely information sharing between the multidisciplinary teams hospital and care home staff sounds simple, but is not as straightforward as it seems.
What was the aim of your project?
I aimed to develop and implement a new information care procedure to make sure care homes were receiving all appropriate information about a patient when they were discharged. We were interested to find out if this process would also lead to improvements in patients’ quality of life, functional ability and Body Mass Index (BMI) on transfer.
How did you carry it out?
I used various methods recommended by the Improvement Science approach. A new discharge form was created through consultation with members of the multi-disciplinary team and community staff, including social work. Staff engagement was vital. Continuous education about the new project was required to inform and engage with new ward staff.
The impact of the project was measured using questionnaires with staff in the ward, care homes, and the liaison mental health team. Patient outcomes were measured using quality of life and functional ability scales, and body mass index (BMI) before and four weeks after discharge. Audits of the new discharge form measured how regularly and correctly staff were using the form.
What was the impact of your project?
Twenty patients were discharged from the ward over 6 months using the new discharge form: 13 were discharged to a care home and 7 returned to their own home. The 13 patients’ discharged to care home were evaluated pre-discharge and post-discharge at 4 weeks by telephone to the care home. One patient died during this time.
Over the six months of the project 98% of professions engaged in the form’s completion. The 12 patients demonstrated an increase in their BMI, 42% improved or maintained their functional ability and 75% improved or maintained their quality of life. All care homes reported a benefit to the increased information to their care of the patient.
This impact of improved sharing of information from hospital to care home appeared to improve patients’ quality of life, function and BMI on their transfer to a care home setting.
What were your conclusions?
The use of the new multi-disciplinary discharge form increased the level and consistency of information disseminated to a care home on discharge. The information aided care homes to shape their care for the patient.
There appears to be a positive impact of improving communication between the ward and care homes on patient outcomes as demonstrated through their BMI, Quality of Life and Functional Ability on discharge. However, this improvement was only measured over a short time frame with a limited number of patients, and without any control group.
What next for the project?
This project has shown that improved information sharing systems can increase the range of important clinical information that is shared and may benefit patient outcomes. I hope to continue to improve the discharge information sharing processes on the ward.
27 January 2017
Dr Mariasole Da Boit (University of Derby), Dr Angus Hunter (University of Stirling) and Dr Stuart Gray (University of Glasgow) have written in The Conversation:
“Fish oil supplements may seem like a relatively recent health fad but they have actually been produced in the UK on a large scale since 1935 by the company Seven Seas Ltd. Since then, the fish oil supplement market has continued to grow, with many beneficial effects claimed for health……….”
See the full article here.
24 January 2017
Dr Edward Duncan has written in The Conversation UK:
“Buckets lists – inventories of things to do before you die – are often developed by people who know they have little time left. It seems like a good idea. But are they really beneficial, or can they cause harm? And is it really useful to generate lists that may – either due to expense or illness – be perceived as unrealistic?”
Please click here for the full article.
15 December 2016
Why personal accounts of cancer treatment in Scotland matter: re-blogging a post for Macmillan Cancer Support Scotland by Prof Mary Wells.
The publication of the personal patient accounts from the Scottish Cancer Patient Experience Survey provided instant publicity thanks to national media coverage but only reflected a fraction of what was in the report.
Compiled from an independent analysis of over 7,000 comments made by more than 2,500 people with cancer, these personalised responses are the stories of individuals whose experiences provide an insight into what matters most to people with cancer from diagnosis to end of treatment.
Whilst the results of the multiple-choice survey questions, published in June, provided an indication of the aspects of care which are experienced positively and those which leave room for improvement, they provide little detail of why or how individual patients experience those aspects of care.
The steering group for the first Scottish Cancer Patient Experience survey deliberately decided to include a greater number of these responses which had been used in the previous…
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“When you hear the word “cancer” probably the last thing that you think of is physical activity. In fact, most of us think of cancer as a death sentence. Treatments for cancer make many people feel lousy and the side effects of treatment include fatigue, anxiety, nausea, vomiting and pain. So it is hardly surprising that people who are diagnosed with cancer are not reaching for their running shoes or gym kit.”
Read Dr Gill Hubbard’s full article Cancer and exercise do mix in The Conversation.
19 October 2016